In the months ahead, the Supreme Court will hear U.S. v. Skrmetti, the case against Tennessee’s ban on hormone therapy for transgender youth – with oral argument likely to be scheduled before the end of 2024. Three Tennessee families with transgender children filed the suit after the state outright banned their children’s healthcare (hormone therapy they rely on for the treatment of gender dysphoria).
The Tennessee families are being represented by Lambda Legal, ACLU and its Tennessee affiliate, and the law firm of Akin Gump Strauss Haur & Feld LLP. The suit argues that Tennessee’s ban violates the U.S. Constitution’s guarantees of equal protection and due process as well as the Affordable Care Act’s Section 1557, which bans sex discrimination in health care. This is because Tennessee’s law specifically states that youth whose gender identity is “consistent with their sex assigned at birth” can access the same hormone therapy treatments that transgender youth are prohibited from accessing. This means that if a cisgender child needed to access hormone replacement therapy to treat a hormonal imbalance they could, while a transgender child diagnosed with gender dysphoria could not access the same treatment. The Tennessee law – and all other state bans on hormone therapy for transgender youth – are clear cases of discrimination on the basis of sex.
What’s at stake?
Since 2021, twenty four states have passed laws banning gender-affirming hormone therapy for youth – with the majority of states passing bans within the past year and a half. The UCLA Williams Institute estimates that there are about 110,300 transgender youth currently living in these states. Although not all transgender youth receive hormone replacement therapy, those who do need this care are now being forced to travel extreme distances and take on significant expenses to access care in a safe state. What was once a regularly scheduled doctor’s appointment with a trusted provider has now become an arduous journey families must make multiple times a year.
Traveling out-of-state for care is complicated, expensive, and puts enormous strain on families. Check out our report “How Far? The Extreme Travel Burden of Bans on Medically Necessary Care fort Transgender Youth” for more information on the distances families in the South are being forced to travel, and the associated costs.
The Supreme Court’s decision will have implications reaching far beyond the Tennessee families who filed the suit. The court’s ruling about whether Tennessee’s ban on hormone replacement therapy for transgender youth is discrimination on the basis of sex, or not, could set a legal precedent with implications for all 24 states that have passed similar laws. Legal advocates believe that if the Supreme Court allows Tennessee’s ban on hormone therapy for youth to stand, the decision could be a first step towards increased legal limits on reproductive healthcare – like abortion, IVF, and birth control. This is because states like Tennessee that have banned hormone therapy for transgender youth are relying heavily on the legal precedent set by Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade and allowed states to ban abortion. Therefore, the court’s decision in U.S. v. Skrmetti could be a major indicator of how the court is interpreting Dobbs., and the type of healthcare bans the court will allow.
When will the Supreme Court hear U.S. v. Skrmetti?
We do not have an exact date yet, but the case is expected to be heard before the end of this year. According to Supreme Court procedure, arguments are heard during the first two weeks of each month from October through December. The case is not listed on the October or November calendars released, so it’s likely to be heard in December or January. The online legal publication SCOTUSblog reported that a decision will likely be made “by late June or early July 2025.”
How can trans youth living in states with gender-affirming care bans continue accessing care?
Regardless of who wins the election, this case will still present a risk to the long-term rights and healthcare access of trans youth in over half the country. And in the meantime, until a decision is made, thousands of families of transgender youth will continue to see their access to critical healthcare banned, forcing them to travel.
Families of transgender youth who are living under gender-affirming care bans and struggling to access the care they need should reach out to Campaign for Southern Equality’s Trans Youth Emergency Project. This program offers logistical and financial support to families navigating the complex and exhausting maze created by bans on gender-affirming care. Our team provides 1-on-1 custom patient navigation services and supports families of transgender youth with emergency grants to help them travel out of state for care. Go to transyouthemergencyproject.org to learn more and fill out a form requesting support.
Want to support trans youth and their families in the months ahead? Donate to the Trans Youth Emergency Project. Since launching in 2023 we have supported 1,100+ families of trans young people and have distributed more than $600,000 in direct emergency grants.
